Prevalence and predictors of Potentially Inappropriate Psychotropic Medication in older adults with psychiatric illness.

Abstract

There is limited information available on the use of Potentially Inappropriate Psychotropic (PIP) medication in older adults having a psychiatric illness. To determine the prevalence of and predictors of prescribing PIP medications in older adults with psychiatric illness. A cross-sectional study was carried out at a tertiary care hospital on 456 patients of either sex, with a median age of 65 years attending the psychiatry outpatient department. Evaluation of PIP medication was done using Beers criteria 2019 and Screening tool of Older Persons Potentially Inappropriate Medication (STOPP) criteria 2015. Bivariate logistic regression was used to find out the predictors of PIP prescribing. Results of the study reflect that a staggering number of older adults, (more than 91% and 73%) out of a total of 456 patients were prescribed with at least one PIP medication identified by Beers criteria and STOPP criteria, respectively. Long-acting benzodiazepine (LABZD) like clonazepam was identified as one of the most commonly prescribed PIP medications by both sets of criteria. Further analysis revealed that older adults from rural background (Odds Ratio (OR) 2.60, 95% Confidence Interval (CI) 1.20-5.65; P=0.015), Tricyclic Antidepressant (TCA) (OR 0.30, 95% CI 0.12-0.75; P=0.010), LABZD (OR 33.72, 95% CI 11.27-100.85; P=<0.001), atypical antipsychotics (OR 22.35, 95% CI 5.31-93.99; P=<0.001) use were most common predictors for PIP medication prescribing. The study suggests that the Beer criteria detects more PIP medication than the STOPP criteria.